Twenty years ago, an extraordinary gallery was launched at Bethlem Royal Hospital, a psychiatric institution set in 270 acres of green space in Bromley, south-east London. The hospital, which had the previous nickname Bedlam, was celebrating its 750th anniversary and a rich history that has inspired books, horror films and television shows. Arts coordinator Karen Risby decided to stage an exhibition of artwork by its patients to coincide with the historic milestone.

Beth Elliott, current director of Bethlem Gallery, takes up the story: “Karen made a call out to people who were either past or current patients of South London and Maudsley NHS Foundation Trust [the medical body that oversees Bethlem]. She was overwhelmed by the quantity and the quality of the work that was submitted.” It soon became apparent to Risby that, “the exhibitors ... had very few opportunities to show their work, so she decided a permanent exhibition space was needed to increase provision and cater to that need”.

Elliott says the aims of the project were twofold – to engage the artistic enthusiasm of patients but also to bring people into the world of the institution for themselves.

“The core motivation to set up the gallery was to respond to the needs and interests of artists with mental health problems,” says Elliott. “However, an equally important motivator was to invite people onto the site of a psychiatric hospital, somewhere that many people fear, and to engage people in learning about mental health through art and art practice, importantly from the personal perspectives of people with lived experience.”

Two decades on, the gallery is celebrating its anniversary with a show called It’s How Well You Bounce which explores the concept of resilience and the ability to deal with adversity. The show features work by artists currently or formerly in care at the hospital as well as a piece by its patron, the Turner Prize-winning artist Grayson Perry, who has been involved with the gallery since 2015.

Perry said of the latest show: “Bethlem Gallery’s 20th anniversary is a great milestone to be celebrating. Art is the greatest asset to mental health I have; it has this amazing ability to go under the radar and it goes down little pathways which are untrodden and yet it’s still a very legitimate way of thinking and feeling and getting on with your life. I hope that Bethlem Gallery continues to provide such vital support to artists.”

Sam Curtis, exhibition curator, explains the themes: “The theme of resilience manifests itself in the works in the exhibition in diverse ways. We see the works of artists who draw on the imagination as a positive and strategic response to life pressures; works that are born out of the artist’s ability to adapt and survive to new and often challenging circumstances; artists that resist or document resistance to social and political pressures.”

It was also important from a holistic view, in the treatment for patients. Curtis says the exhibition will help “artists … reroute negative thoughts into something more positive through their art making, [for] artists [to help] map, shape and transform their identity through art making and therapy. Importantly we can encounter artworks and projects that critique the notion of resilience that says we need to ‘man or woman-up’ and bounce back from adversity.

“It’s How Well You Bounce includes artworks that explore a specific aspect of resilience, as well as artworks that come from artistic practise that is itself a form of resilience.”

Curtis is keenly aware that the creative process is not necessarily a safe one. “For some people, art-making can contribute to their well-being – that could be an increase in confidence, expressing thoughts and feelings through a visual language where sometimes our words fail, or developing coping mechanisms.

“Here at Bethlem Royal Hospital, the occupational therapy department provides an art studio for patients ... But the practice of art-making can also make us vulnerable and can be seen as a risk-taking occupation to engage with,” says Curtis.

“Artists share their thoughts and bare their souls; they invest themselves in an activity for little or no financial gain, and they take risks in creating something highly subjective and open to endless reworkings. The process of art-making is different for everyone and its therapeutic potential may fluctuate depending on a multitude of external and internal factors that might be bearing down on us at that time.”

And the art on show in It’s How Well You Bounce definitively illustrates the risks that the artists behind the pieces are taking.

'Mr X' outside the Bethlem Gallery. Courtesy Bethlem Gallery

In an exhibition of diverse forms of art, John Mc has produced a piece of HD video, Resilience (2016), which is a reliving of his own experience of recovery. John Mc examines all the events that befell him during his spell on a psychiatric ward, presenting them from his own viewpoint, reversing the idea that we immediately come to – that the patient is the one under observation. Instead we get the artist’s take on what his spell on the ward meant to him.

A-tation (2017) by Matthew is another piece that is essentially a subjective account of what mental illness can feel like. The artist presents a collection of objects scavenged from the grounds of Bethlem Royal Hospital, including hospital chairs and electronic cables, a stark reminder of how the exhibitors in the show are bound by the constraints of their situation, but also a joyous celebration of how beauty can be found in the most unlikely and obscure artefacts. The oil painting Unemployed (1972) by Maureen Scott is an extraordinary vision, inspired by her childhood growing up in an impoverished background. A family is portrayed against the chaos of a bedsit, with a family of seven overwhelmed by a clutter of junk. Scott herself grew up in a state of want, painting by candlelight, and she brings into relief the key connection between poverty and mental illness and the lack of relief that being penniless can bring on.

'Unemployed' (1972) by Maureen Scott shows the chaos of a family struggling in a bedsit. Courtesy Bethlem Gallery

Perry’s artwork, Map of an Englishman (2004), is another take on the multifaceted nature of mental conditions. Presented as an old-fashioned cartographic representation of a chart, it features the various temperaments of the eponymous Englishman. Areas of the map are labelled with conditions such as Bad Manners, Delirium, Happiness and Schizophrenia. It echoes the phrenological diagrams that dominated psychology until the age of Sigmund Freud opened up our minds to what exactly our minds were up to.

'Journey to Recover' (2016), a video still by John Mc. Courtesy Bethlem Gallery

Esther Maxwell-Orumbie’s take on the theme of the exhibition was to create a tunic embroidered with the image of a chameleon, an animal known for its ability to blend in to different surroundings, the ne plus ultra in adaptability. She then was photographed in the tunic in a variety of locations around London. She says of her work, “I adjust and adapt but I retain my culture, I am who I am – I don’t need your approval.”

As to the next 20 years for the gallery, Elliott told After Nyne Magazine that she hoped one day such a space wouldn’t have to exist. “Well, maybe in the long distant utopian future we won’t be needed; maybe all hospitals will become artistic retreats and the art world will be a more supportive and flexible place ... but in the meantime we plan to continue to support artists in their interests and endeavours.”

It’s How Well You Bounce is at Bethlem Gallery, Bromley, until October 28. For more information, visit bethlemgallery.com